FORM 1023-EZ for MISSOURI ASSOCIATION MEDICAL STAFFSERVICES

Field Data
EIN 82-0702358
Case Number EO-2019038-000079
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MISSOURI ASSOCIATION MEDICAL STAFFSERVICES
Organization’s Mailing Address 621 S NEW BALLAS ROAD SUITE 7006B
City SAINT LOUIS
State MO
ZIP 63141
Accounting period End 12
Primary contact name TRACY BROOKS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TRACY BROOKS
PRESIDENT
621 S NEW BALLAS ROAD
SAINT LOUIS MO 63141

Officer/Director/Trustee Two

KELLY BRANDT
PRESIDENT ELEC
101 PINE TREE LANE
FREEBURG IL 62243

Officer/Director/Trustee Three

DUSTIN JACKSON
SECRETARY
1235 E CHEROKEE STREET
SPRINGFIELD MO 65804

Officer/Director/Trustee Four

DEYCA MCFARLANE
TREASURER
621 S NEW BALLAS ROAD SUITE 7006B
SAINT LOUIS MO 63141

Organization’s website HTTP://WWW.NAMSS.ORG/ABOUT/STATEASSOCIATIONWEBSITES/MISSOURIASSOCIATIONMEDICALSTAFFSERVICES.ASPX
Organization’s email MOAMSS.BOARD@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/90
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B03 - Professional Societies, Associations
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name TRACY BROOKS
Signature Title PRESIDENT
Signature Date 1/29/19
EIN 82-0702358
Case Number EO-2019038-000079
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MISSOURI ASSOCIATION MEDICAL STAFF SERVICES
Organization’s Mailing Address 621 S NEW BALLAS ROAD SUITE 7006B
City SAINT LOUIS
State MO
ZIP 63141
Accounting period End 12
Primary contact name TRACY BROOKS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TRACY BROOKS
PRESIDENT
621 S NEW BALLAS ROAD
SAINT LOUIS MO 63141

Officer/Director/Trustee Two

KELLY BRANDT
PRESIDENT ELEC
101 PINE TREE LANE
FREEBURG IL 62243

Officer/Director/Trustee Three

DUSTIN JACKSON
SECRETARY
1235 E CHEROKEE STREET
SPRINGFIELD MO 65804

Officer/Director/Trustee Four

DEYCA MCFARLANE
TREASURER
621 S NEW BALLAS ROAD SUITE 7006B
SAINT LOUIS MO 63141

Organization’s website HTTP://WWW.NAMSS.ORG/ABOUT/STATEASSOCIATIONWEBSITES/MISSOURIASSOCIATIONMEDICALSTAFFSERVICES.ASPX
Organization’s email MOAMSS.BOARD@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/90
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B03 - Professional Societies, Associations
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name TRACY BROOKS
Signature Title PRESIDENT
Signature Date 1/29/19

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